Sucralfate is a unique oral drug. Chemically, it is a complex of the disaccharide sugar, sucrose, combined with sulfate and aluminum. It is minimally absorbed into the body, and its actions are entirely on the lining of the stomach and duodenum. Although its mechanism is not entirely understood, the following actions are thought to be important for its beneficial effects:
- sucralfate binds to the surface of ulcers (attaching to exposed proteins) and coats the ulcer, thus protecting the ulcer surface to some extent from further injury by acid and pepsin;
- sucralfate directly inhibits pepsin (an enzyme that breaks apart proteins) in the presence of
- stomach acid;
- sucralfate binds bile salts coming from the liver via the bile thus protecting the stomach lining from injury caused by the bile acids;
- sucralfate may increase prostaglandin production, and prostaglandins are known to protect the lining of the stomach.
Sucralfate was approved by the FDA in 1981.